Medical providers push back against Title X’s new anti-abortion provisions

The Trump administration’s proposal to strip federal funding from family planning programs that refer women to providers where they can get an abortion would disproportionately impact low-income Seattleites, local reproductive health care providers say.

On June 1, the U.S. Department of Health and Human Services published the much-discussed proposed revision to Title X, the 1970 statute that created the national grant program on reproductive health care and affordable birth control. The proposed rule ensures that no providers that receive Title X funding could offer an abortion or present a list of providers that perform abortions unless a “women who is currently pregnant clearly states that she has already decided to have an abortion.”

Such an enforcement will breed a litany of unintended consequences, Planned Parenthood of the Great Northwest and the Hawaiian Islands (PPGNHI) Communications Manager Katie Rogers wrote in an email to Seattle Weekly. Currently, providers educate pregnant women on prenatal care and delivery, infant care, abortion services, foster care, and adoption.

The proposed rule also strips the requirement that birth control methods be “medically approved,” and does not require federally funded programs to offer every form of birth control. This would “make it impossible for patients to get birth control or preventive care from reproductive health care providers like Planned Parenthood,” Rogers wrote.

The federal agency is taking public comments on proposed rule. Comments must be submitted to a document repository by July 31 to be considered. No public comments had been made on the proposal as of Friday afternoon.

Planned Parenthood fills the wide gap between people in need of reproductive health care and available services, Rogers posited. In 2017, PPGNHI provided Title X clinical services to nearly 40,000 people in Washington state, 81 percent of whom were low-income teens or people between 20-44 years old.

“This policy is a direct attack on low-income women and the most vulnerable. These are the very people who the Title X program is supposed to serve,” wrote Rogers. “This will disproportionately hurt women who identify as members of racial or ethnic communities that often face significant health challenges due to systemic inequities. Out of the 4 million family planning patients served by Title X, more than half are women of color: 21 percent of all Title X clients identify as black or African American, and 32 percent identify as Hispanic or Latino.”

Along with disproportionately impacting low-income women in Seattle, the proposed rule would also affect residents in Eastern Washington where hospitals are often religiously affiliated, and medical professionals could turn away women seeking abortions. “This ruling impacts the totality of reproductive health care,” Trust Women Seattle CEO Julie Burkhart wrote in an email to Seattle Weekly. “These punitive rules by the Trump Administration not only bars access from the constitutionally protected right to choose to terminate a pregnancy, but it also redirects over $260 million of family planning resources to clinics and programs that do not offer full spectrum reproductive health services. Abortion is an important part of health care, and limiting one aspect of that care restricts access to the best health care choice for the patient.”

Although the Trust Women Seattle clinic does not receive Title X funding, the proposed rule that bars medical professionals from referring women to the clinic or any other abortion provider in Seattle makes “resources and information on health care all the more difficult to get.” Burkhart referred to the proposal as a “gag rule” that would increase maternal mortality rates and “holds medical providers hostage.”

There is also a possibility that Title X funding could be redirected to Crisis Pregnancy Centers (CPCs) that counsel women against having an abortion. In a recent NPR report, several abstinence-only education organizations said that they planned to apply for the Title X funding in light of the new regulations.

“Providing Title X funding to CPC’s is an unconscionable move, but it’s not altogether a surprising idea from this federal government,” Burkhart wrote. “The Trump gag rule holds the medical community hostage to funding and restricts those professionals from referring or even discussing the full spectrum of reproductive health options to patients. Essentially, the law puts providers in the position of having to lie to patients to continue to receive millions of dollars in funding, so directing that funding to centers that seek to lie to patients like CPC’s is the logical extension of the dangerous anti-choice policies of the Trump administration.”